Beryl

More about the Beryl option

Get access to a healthcare provider who belongs to the GEMS network. You don’t have to pay for treatment or book an appointment and pay out -of-pocket.

• We encourage you to nominate a General Practitioner (GP) if you’re on the Beryl option, to coordinate your healthcare needs. However, you won’t be penalised if you don’t nominate a GP.

• If you visit a non-network GP, your consultation will be paid from your non-nominated benefit. This benefit allows for a maximum of three visits per family (annually) to a GP who isn’t part of the GEMS network.
• The Scheme will fund 70% of your medical expenses and you will have to pay a co-payment of the remaining 30%. If you deplete your non-nominated benefit and you consult a non-nominated GP, your claim will not be paid by the Scheme.

• Visits to a specialist must be referred by your nominated GP. Your nominated GP must also call our call centre to get pre-authorisation before you can visit a specialist. 
• Pathology and radiology tests (blood tests and x-rays) must be referred by your nominated GP. These tests must be in line with the GEMS formulary (list of approved tests or services) for Beryl.